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Individual
STEPHANIE C JACKSON
Active
Individual
STEPHANIE C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801095974
MI
Other
Enumeration date
07/15/2009
Last updated
07/31/2023
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